Compassionate use of delamanid in adults and children for drug-resistant tuberculosis: 5-year update.

BACKGROUND: Although delamanid has been approved for the treatment of multidrug-resistant TB (MDR-TB) in numerous regions, in areas where it is not yet registered it can be accessed as part of salvage therapy (in particular for those patients with limited treatment options) via the Otsuka compassionate use programme. Here we present the analysis of interim treatment outcomes by 24 weeks of more than 200 MDR-TB patients globally who received delamanid under this programme. METHODS: We evaluated treatment efficacy with respect to culture negativity at 24 weeks, as well as the safety profile of delamanid, in an MDR-TB patient cohort treated under compassionate use between 2014 and 2019. RESULTS: Among patients who received delamanid as part of a multidrug regimen, 123 (61%) out of 202 had extensively drug-resistant TB (XDR-TB), 66 (33%) out of 202 had HIV co-infection and 34 (17%) out of 202 were children aged between 6 and 17 years. Of those patients who were culture positive at delamanid treatment initiation and who completed 24 weeks of delamanid treatment in combination with other anti-tuberculosis (TB) drugs, culture negativity was achieved in 116 (79%) out of 147 cases. The corresponding rates of culture negativity for patients with XDR-TB and HIV co-infection, as well as the paediatric subgroup were 69 (77%) out of 90, 44 (92%) out of 48 and 20 (80%) out of 25, respectively. QT interval prolongation was the most frequently observed serious adverse event and was reported in 8% of patients receiving delamanid. Overall, treatment safety outcomes did not reveal any new or unidentified risks. CONCLUSIONS: The use of delamanid combined with other active drugs has the potential to achieve high rates of culture negativity in difficult-to-treat drug-resistant TB cases, with a favourable safety profile.

Pregnancy Apps for Self-Monitoring: Scoping Review of the Most Popular Global Apps Available in Australia.

Digital health tools, such as apps, have the potential to promote healthy behaviours, especially self-monitoring, which can facilitate pregnancy management and reduce the risk of associated pregnancy health conditions. While pregnancy apps are popular amongst pregnant women, there is limited information about the overall quality of their content or self-monitoring tools and the number of behaviour change techniques (BCTs) that they include. The aim of this study was thus to assess the quality of pregnancy apps for self-monitoring, and their usage of BCTs. We identified pregnancy apps by web scraping the most popular global apps for self-monitoring in the Apple App Store and Google Play Store available in Australia. The app quality was evaluated using the scorecard approach and the inclusion of BCTs was evaluated using the ABACUS tool. We identified 31 pregnancy apps that met our eligibility criteria. We found that pregnancy apps tended to score the highest in the domains of 'cost and time', 'usability', and 'technical', and lowest on 'clinical' and 'end-user requirements'. Additionally, the majority of apps contained minimal BCTs. Based on our findings, we propose a digital health scorecard visualisation that would break down app quality criteria and present them in a more accessible way to clinicians and pregnant users. We conclude that these findings highlight the shortcomings of available commercial pregnancy apps and the utility of a digital health scorecard visualisation that would empower users to make more informed decisions about which apps are the most appropriate for their needs.

A mixed-methods study exploring women's perceptions and recommendations for a pregnancy app with monitoring tools.

Digital health tools such as apps are being increasingly used by women to access pregnancy-related information. Conducted during the COVID-19 pandemic, this study investigated: (i) pregnant women's current usage of digital health tools to self-monitor and (ii) their interest in theoretical pregnancy app features (a direct patient-to-healthcare-professional communication tool and a body measurement tool). Using a mixed methods approach, 108 pregnant women were surveyed and 15 currently or recently pregnant women were interviewed online. We found that pregnant women used digital health tools to mainly access pregnancy related information and less so to self-monitor. Most participants were interested and enthusiastic about a patient-to-healthcare-professional communication tool. About half of the survey participants (49%) felt comfortable using a body measurement tool to monitor their body parts and 80% of interview participants were interested in using the body measurement to track leg/ankle swelling. Participants also shared additional pregnancy app features that they thought would be beneficial such as a "Digital Wallet" and a desire for a holistic pregnancy app that allowed for more continuous and personalised care. This study highlights the gaps and needs of pregnant women and should inform all stakeholders designing pregnancy digital healthcare. This study offers a unique insight into the needs of pregnant women during a very particular and unique period in human history.

Psychometric properties of the Teenage Executive Functioning Inventory (TEXI): A freely available questionnaire for assessing deficits in working memory and inhibition among adolescents.

The Childhood Executive Functioning Inventory (CHEXI) and the Adult Executive Functioning Inventory (ADEXI) are reliable and valid rating instruments for assessing working memory and inhibitory control. However, a teenage version of this instrument has not been available, and the aim of the present study was therefore to investigate the psychometric properties of the Teenage Executive Functioning Inventory (TEXI). After interviewing both researchers/clinicians and adolescents themselves, a questionnaire with 20 items was created. Data from adolescents age 13-19 years (n = 302) and their parents were thereafter collected. Factor analysis showed that the TEXI has two clear factors: working memory and inhibition. Further, the TEXI was shown to have high reliability in terms of internal consistency (≥ .85), split-half reliability (≥ .81) and inter-rater reliability between self-ratings and parent ratings (.82). In sum, the TEXI is a reliable questionnaire for measuring working memory and inhibition in adolescents. The two versions of the TEXI are presented in the appendices of this paper and they will be freely available on the Internet.

ASSESSMENT OF THE ROLE OF PRIMARY HEALTH CARE IN TUBERCULOSIS CONTROL IN SERBIA.

INTRODUCTION: At the onset of the 21st century, tuberculosis is still a public health problem. Due to the implementation of tuberculosis control program in Serbia, there is no fear of an epidemic. Within the reform of the health care system, the service for pulmonary diseases is being restructured, calling for strengthening the role of primary health care. This study was aimed at analyzing the current role of primary health care in tuberculosis control. MATERIAL AND METHODS: A cross-sectional study was conducted between the 12th and 30th September, 2010. For evaluating the current role of primary health care in tuberculosis control, four questionnaires were designed based on the "Performance assessment questionnaire regarding TB control for use in PHC", Journal Brasileiro de Pneumologia, print version ISSN 1806-3713 (vol. 35, no 6, Sao Paulo, June 2009). The following methods were used to analyze the results: descriptive statistical analysis, Student's T-test, Fisher's analysis of variance. The reliability of the results was tested with Cronbach's alpha and factor analysis. The level of significance in all the methods bordered 0.05. RESULTS: Primary health care does not participate in tuberculosis control in line with the possibilities of the existing legal framework. Although the paper proves that tuberculosis notification rate is higher in the areas less covered by the pneumophysiological service, the role of primary health care does not differ from the areas fully covered. CONCLUSION: There is a need for strategic empowerment of the primary health care system to be actively involved in the diagnostics. treatment and follow up of tuberculosis in Serbia.

Radionuclide concentrations in samples of medicinal herbs and effective dose from ingestion of ¹³7Cs and natural radionuclides in herbal tea products from Serbian market.

The objective of this study is to evaluate natural and artificial radioactivity levels in 18 different samples of medicinal herbs from Serbian market. The activity concentrations of (238)U, (232)Th, (40)K, and (137)Cs were measured using gamma spectroscopy system with a high-purity germanium detector. The activity concentrations of (238)U, (232)Th, (40)K, and (137)Cs were found to be in a range of 0.6-8.2, 1.7-15.1, 126-1243.7, and 0.3-8.8 Bq/kg, respectively. The annual whole body doses from ingestion of (137)Cs and natural radionuclides for an adult person who consumed herbal tea from these medicinal herbs were found to be 2.5-469.9 nSv for (137)Cs, 0.7-9.7 nSv for (238)U, 0.3-2.8 nSv for (232)Th, and 1026.0-10,132.0 nSv for (40)K. These doses are not hazardous to public health. The obtained results were compared with correspondent studies conducted worldwide.